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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
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Methodology•Download Data
  1. Home
  2. Providers
  3. Peachstate Health Management Llc
🔬
Organization

Peachstate Health Management Llc

NPI: 1972888139
Gainesville, GA
10 years of data
Clinical Laboratory
$26.9M
Total Payments
351.3K
Beneficiaries
523.8K
Services
3.43x
Markup Ratio

Peer Comparison

96th
percentile in specialty
This provider$26.9M
Specialty median$1.9M

📋 Key Findings

1Billed $26.9M over 10 years
23.43x markup ratio (above median)
396th percentile in Clinical Laboratory by payments
47 procedures with >3x markup
✓ No flags detected

🔎 Data Analysis

This provider's $26.9M in total Medicare payments ranks in the 96th percentile of Clinical Laboratory providers nationally.

This provider's billing patterns fall within normal ranges for their specialty.

AI-generated analysis based on Medicare payment data.

Annual Medicare Payments

Annual Services Provided

Avg Payment per Service

Markup Ratio Over Time

Submitted Charges vs. Medicare Payments

Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.

YearAvg SubmittedAvg PaidMarkup RatioGap per ServiceTotal PaymentsServicesBeneficiaries
2014$112.99$55.252.05x$57.74$4.3M143.6K102.7K
2015$229.76$148.861.54x$80.90$5.9M246.3K157.7K
2016$505.32$299.531.69x$205.79$6.0M41.8K34.0K
2017$369.89$178.442.07x$191.45$5.0M30.5K24.1K
2018$272.50$59.484.58x$213.02$2.7M23.3K17.7K
2019$207.64$36.215.73x$171.43$931.3K10.3K7.5K
2020$380.49$124.763.05x$255.73$825.0K8.0K2.7K
2021$387.57$125.553.09x$262.02$800.3K13.0K3.2K
2022$388.32$123.963.13x$264.36$442.4K6.7K1.6K
2023$468.56$152.453.07x$316.11$32.4K213135

Top Procedures (20)

G0483Drug test def 22+ classes⚠ 6.4x markup
$4.7M
20.7K services$227.99/svc6.38x markup
81401Molecular pathology procedure level 2
$1.2M
9.1K services$136.99/svc2.03x markup
U00042019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r⚠ 3.5x markup
$1.2M
13.9K services$85.21/svc3.49x markup
81226Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) common variants
$1.2M
2.6K services$442.09/svc2.05x markup
G0480Drug test def 1-7 classes⚠ 5.6x markup
$1.1M
9.9K services$112.71/svc5.62x markup
81211Gene analysis (breast cancer 1 and 2) full sequence and common duplication or deletion variants
$1.0M
486 services$2.1K/svc1.10x markup
81400Molecular pathology procedure level 1
$979.0K
8.1K services$120.17/svc1.91x markup
80307Testing for presence of drug⚠ 8.3x markup
$919.7K
13.2K services$69.44/svc8.27x markup
G0482Drug test def 15-21 classes⚠ 6.9x markup
$878.1K
4.5K services$194.49/svc6.94x markup
81241Gene analysis (coagulation factor V) Leiden variant
$732.4K
9.0K services$81.27/svc2.16x markup
81408Molecular pathology procedure level 9
$646.8K
400 services$1.6K/svc1.44x markup
81240Gene analysis (prothrombin, coagulation factor II) A variant
$591.6K
9.0K services$65.66/svc2.16x markup
81225Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 19) common variants
$575.6K
2.0K services$285.93/svc1.92x markup
81402Molecular pathology procedure level 3
$531.1K
3.3K services$163.02/svc1.72x markup
81291Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants
$527.7K
9.0K services$58.48/svc2.17x markup
G0481Drug test def 8-14 classes⚠ 6.4x markup
$381.4K
2.5K services$151.83/svc6.42x markup
81317Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) full sequence analysis
$368.8K
481 services$766.66/svc1.39x markup
G6046Dihydromorphinone
$355.5K
10.4K services$34.27/svc2.06x markup
83992PCP drug level⚠ 3.3x markup
$321.6K
16.4K services$19.62/svc3.34x markup
81292Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) full sequence analysis
$309.4K
488 services$634.09/svc1.28x markup
Show detailed table ▾
CodeDescriptionServicesPaymentsAvg/ServiceMarkup
G0483Drug test def 22+ classes20.7K$4.7M$227.996.38x
81401Molecular pathology procedure level 29.1K$1.2M$136.992.03x
U00042019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r13.9K$1.2M$85.213.49x
81226Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) common variants2.6K$1.2M$442.092.05x
G0480Drug test def 1-7 classes9.9K$1.1M$112.715.62x
81211Gene analysis (breast cancer 1 and 2) full sequence and common duplication or deletion variants486$1.0M$2.1K1.10x
81400Molecular pathology procedure level 18.1K$979.0K$120.171.91x
80307Testing for presence of drug13.2K$919.7K$69.448.27x
G0482Drug test def 15-21 classes4.5K$878.1K$194.496.94x
81241Gene analysis (coagulation factor V) Leiden variant9.0K$732.4K$81.272.16x
81408Molecular pathology procedure level 9400$646.8K$1.6K1.44x
81240Gene analysis (prothrombin, coagulation factor II) A variant9.0K$591.6K$65.662.16x
81225Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 19) common variants2.0K$575.6K$285.931.92x
81402Molecular pathology procedure level 33.3K$531.1K$163.021.72x
81291Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants9.0K$527.7K$58.482.17x
G0481Drug test def 8-14 classes2.5K$381.4K$151.836.42x
81317Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) full sequence analysis481$368.8K$766.661.39x
G6046Dihydromorphinone10.4K$355.5K$34.272.06x
83992PCP drug level16.4K$321.6K$19.623.34x
81292Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) full sequence analysis488$309.4K$634.091.28x

Markup Analysis

Charge-to-Payment Ratio

3.43x

This provider submits charges 3.43 times higher than what Medicare actually pays.

What This Means

A markup ratio of 3.43x means for every $100 Medicare pays, this provider initially charges $343. This is higher than the national average.

Location

Gainesville, GA

Provider Verification

Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.

Similar Providers

Other Clinical Laboratory providers in GA for peer comparison.

Peachstate Health Management Llc (you)
$26.9M
Quest Diagnostics Clinical Laboratories Inc⚠️
$599.2M
Bakotic Pathology Associates, Llc
$87.9M
Clinical Laboratory Services, Inc.
$60.1M
Lifebrite Laboratories, Llc
$48.1M
Show detailed table ▾
ProviderLocationTotal PaymentsStatus
Quest Diagnostics Clinical Laboratories IncTucker, GA$599.2M⚠️ Flagged
Bakotic Pathology Associates, LlcAlpharetta, GA$87.9M✓ Clear
Clinical Laboratory Services, Inc.Winder, GA$60.1M✓ Clear
Lifebrite Laboratories, LlcBrookhaven, GA$48.1M✓ Clear

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Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • National Plan and Provider Enumeration System (NPPES)

Last Updated: February 2026 (data through 2023, the latest CMS release)

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.

Believe this data is inaccurate? Dispute this data